Ciliochoroidal detachment after Ahmed glaucoma valve implantation: a retrospective study

Analysis of risk factors and ocular hypotony characteristics in choroidal detachment after penetrating glaucoma surgery

PURPOSE

To analyze the risk factors and ocular hypotony characteristics of choroidal detachment (CD) after penetrating glaucoma surgery and to compare between eyes with and without CD.

METHODS

This retrospective study enrolled 173 eyes of 168 patients. Patients who underwent trabeculectomy or Ahmed glaucoma valve implantation due to medically uncontrolled glaucoma and who had intraocular pressure (IOP) < 9 mmHg at any time during the first postoperative week were included.

RESULTS

The study population consisted of 61 (36.3%) females and 107 (63.7%) males with a mean age of 60.7 ± 14.2 years. The postoperative median follow-up time was 24 months (range, 12-40 months). Postoperatively, CD developed in 47 (27.1%) eyes. Multivariate analyses demonstrated that eyes with high preoperative IOP (> 40 mmHg) were 12.1 times more likely to develop CD (p = 0.000) and that presence of IOP < 9 mmHg on the first day of surgery increased the CD risk 3.8 times (p = 0.002); male gender raised the risk 2.7 times (p = 0.028). The mean preoperative IOP in CD eyes was significantly higher than in non-CD eyes (p = 0.000). The mean IOP change between preoperative and lowest IOP was significantly greater in those with CD than in those without CD (p = 0.000). The mean lowest IOP in the CD eyes was significantly lower than in the non-CD eyes (p = 0.037). For the surgical failure rate, no significant difference was found between the CD and the non-CD groups (p = 0.14).

CONCLUSIONS

The present study demonstrated that high preoperative IOP, presence of IOP < 9 mmHg on the first postoperative day, and male gender were significantly associated with CD after penetrating glaucoma surgery. Choroidal detachment accompanied by hypotony did not affect the final outcome negatively.